GMR 2009: Goal 4: Reduce Child Mortality

Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate

The under-five mortality rate has fallen in all regions since 1990, and some regions have come close to being on track to meet MDG Target 4.A. However, in most countries, the rate has not declined fast enough to meet the target by 2015, and over three-quarters of countries with available data are not on track. Nearly half of all deaths of children under five occur in Sub-Saharan Africa. Malnutrition, as well as lack of access to water and sanitation infrastructure, contributes to the poor health and death of young children. The leading cause of childhood deaths, including pneumonia, diarrhea, malaria, and measles, can easily be prevented through basic health service improvements and interventions, such as insecticide-treated mosquito nets and vaccinations.

The under-five mortality rate is the probability that a newborn will die before reaching age five (expressed as a rate per 1,000). At an aggregate level, none of the regions is on track to achieve the under-five mortality target, though all regions except South Asia and Sub-Saharan Africa have come close. However, as MDG 4 Figure 2 shows, most countries are off track. Regional estimates of child mortality are based on data covering 99.9 percent of developing countriesâ€™ total population.

Data are available for all but 2 countries on the under-five child mortality rate, but only 33 of the 142 countries with available data have achieved or are on track to achieve the target by 2015. None of the 46 Sub-Saharan African countries with available data is on track to reach the target. None of the fragile states has attained the target and only 1 of 34 is on track to reduce by two-thirds the 1990 under-five mortality rate.

Assessment of measles immunization rates shows a more positive picture for some regions. Though an official target has not been set, assessment is based on a target of achieving a 95 percent measles immunization rate by 2015. Twenty-one of 23 Europe and Central Asian countries with available data have already achieved this target, while 6 of 8 South Asian countries are either on track or have already achieved the target. About half of the countries in East Asia and the Pacific are not on track. Sub-Saharan Africa and fragile states also lag behind.

Measles vaccination coverage is defined as the percentage of children ages 12â€“23 months who received measles vaccinations before 12 months or at any time before the survey was administered. Since 1990, the coverage of measles vaccinations has increased in all six regions, with the greatest improvements occurring in Sub-Saharan Africa and South Asia. Measles vaccination coverage in South Asia increased from 56 percent in 1990 to 71 percent in 2007. The vaccination rate for Europe and Central Asia (83 percent) surpassed the average rate for high-income countries (97 percent) in 2007.